Neoadjuvant chemotherapy and radiotherapy for the treatment of advanced hypopharyngeal carcinoma.
OBJECTIVE
To evaluate the efficacy of the neoadjuvant chemotherapy and radiation therapy in treatment of patients with advanced hypopharyngeal cancer, which is notorious for its poor prognosis and severe surgical morbidity with functional deficits.


METHODS
Medical records of 62 patients with squamous cell carcinoma of the hypopharynx, Stage III or IV (AJCC, 1992), were retrospectively reviewed.


RESULTS
Neoadjuvant chemotherapy showed an overall response rate of 87% and a complete remission (CR) rate was 67% following chemotherapy and radiation therapy. The patients who did not show CR after chemotherapy had a high likelihood of treatment failure, even though they achieved CR following subsequent radiotherapy. Thirteen of 30 patients were able to preserve their larynges for more than 3 years by chemotherapy and radiation.


CONCLUSIONS
This approach appeared to be as effective as radical surgery with postoperative radiation therapy without comprising survival. To improve the cure rates, we need to develop better strategies to increase CR rates with chemotherapy and determine the best treatment option for patients who are partially or nonresponsive to chemotherapy.
Kim
K H
KH
Department of Otolaryngology, Seoul National University, College of Medicine, Korea.
Sung
M W
MW
Rhee
C S
CS
Koo
J W
JW
Koh
T Y
TY
Lee
D W
DW
Heo
D S
DS
Park
C I
CI
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome